Better Living Through Chemistry

I'm feeling like a bit of a fraud. The one remark that I hear over and over again from all of my wonderfully supportive friends and family is that my attitude is "great", "amazingly positive", etc. I suppose I am pretty positive, but I have to admit that my attitude is chemically enhanced. Yes, I have the wonderful Vicodin and Percocet which make me kind of loopy. But while I was in Kessler, I was also put on, what I like to call "happy pills". The brand name is Celexa and it is an anti-depressant.

While I was in Kessler, Joyce, the center's psychologist, came to talk to me in the gym one day. The woman had me pegged within 10 minutes. She said she could quite literally see the control I was exerting as the emotions roiled right beneath the surface. After talking further she said, "What would you say if I suggested putting you on an anti-depressant?' I said, "You wouldn't be the first." I was never the most emotionally stable person to begin with for a variety of reasons. I was in kind of a holding pattern type of depression before the accident, unable to figure out how to get to the next step in my life. I also tend to tamp down the emotions and keep a tight rein on them. I hate letting people see me cry.

Three weeks after the accident, I had never really let go of my feelings. I had cried a little in frustration while waiting for my hip surgery to be scheduled. I had cried a little in anger and frustration when I had to ring 3 times and wait 30 minutes for someone to bring me a bed pan, When the aide finally did bring it, she asked why I was crying and I said, "They're not tears. It's urine leaking out of my eyeballs because I have to pee so badly." One thing that made me not want to let go of my emotions while I was in the hospital was multiple admonishments from nurses and aides when I did cry a little. They would tell me that I had no reason to cry because I was alive and I would walk again and that was more than some people.

I think another reason why I hadn't really cried about the accident and the situation was that I was still sort of in denial about the severity of the accident and my injuries. When I was in the emergency room, I called my boss to tell him I didn't think I would make it into the office on Monday. When I got done with the surgeries I figured I'd be going back to work in a month. A bit unrealistic I know now.

That morning, three weeks to the day after the accident, I woke up and I could feel it coming. All I wanted to do was cry. Of course, since I don't want others to see me cry, I struggled to keep the lid on it as I ate breakfast and got dressed for the day. As soon I was set in my wheelchair, I wheeled myself out of the room, down the hall and out the door to the patio. I kept my back to the building and the torrent unleashed. I cried. Not a couple of tears, but huge body wracking sobs. The nurse came out and asked if I was okay and I told her that I just needed to be alone for a few and let it out and she left. As the tears kept coming, another woman came out and set a box of tissues down on the table next me and sat quietly on the bench. Eventually as the sobs petered out, she said, "Sometimes you just need to cry. It's okay." She had been visiting with her father and saw me out the window. We talked a little about my frustrations and my pain. My loss of independence and control over my life. Actually, I talked and she listened. She didn't offer platitudes or tell me I had nothing to cry about. She was just there. I never found out her name, but I will never forget her and her kindness.

I think the major component of my good attitude is a sort of acceptance. I've always been the type of person, who when confronted with an obstacle or challenge, just sets out to deal with because there is no choice in the matter. My brother and I would joke in the hospital that there was no such thing as dignity and modesty in a hospital. So I accepted it and just went with the flow, it made life easier. I joked when the ortho residents, two young guys I referred to as Tweedledee and Tweedledum, came in to change my surgical dressings. I mean, what else can you do when your naughty bits are exposed to the world while they are sticking gauze to your ass and then on your abdomen, taping it in such a way, that I think the hospital will charge me for a Brazilian bikini wax. Another time, while under the influence of lots of morphine, they rolled me to get to the ass bandages and I ended up with my face right in the crotch of a very cute resident. I looked up at him and said, "You're very cute, but I usually at least get dinner first." In another bed pan incident, I had rung for a bed pan and the aide who came in was a young man named Michael. He paused and said, "Would you like me to send in a female aide?" I told him no and that I was sure I didn't have any bits he hadn't seen before. (Although I'm also pretty sure he wasn't interested in my type of bits...) He turned out to be one of my favorite aides.

By my last days at University Hospital, I was so tired of being poked and prodded and taped and answering the same questions over and over and then being discussed like I wasn't even there. Since the hospital was a teaching hospital, every morning the roving band of students (who we referred to as "the pod" or "the horde") would come in and go over my case. One morning, they walked in and I said, "So Doc, have you figured out what's wrong with me yet?" One student laughed out loud, but the rest just looked confused.

Ultimately, I think my attitude about the whole situation comes from the idea that if I don't laugh about it, I'll cry. Things are what they are. I can't change what happened, all I can do is get through it. And the way to get through it is to focus on the good things and the funny parts. Of course a little chemical boost makes this a lot easier. Scott says that I've become a lot more even tempered since starting the Celexa. I suppose that's one more good thing.

Scarred for life

The worst part of this whole recuperation process is the inactivity. I was a reasonably active adult before this. Back when I originally started this blog I wore a pedometer all day over the course of a few normal days and discovered that on weekdays I walked an average of 2 1/2 miles just living my life. And on weekends during the spring/summer/fall, I would hike 4 -7 miles on the weekend when I could.

Before the accident, my brother Chris told me that he wanted to get back to hiking, it had been a couple years since we had been hiking together. I was excited, especially since my car died in early March and I had made the decision not to replace it right away. If Chris wanted to hike on a regular basis then I would have a larger range of options for hiking and I wouldn't have to rent a car to go. Of course the accident changed all that. Chris now no longer has a car for the summer either. And of course physically neither one of us are going to be walking the trails this year. I'll miss getting out to nature, the smells the sights and the sounds. Grrr... Arrgh

I'm doing some exercises, but I'm basically in a holding pattern until I can put weight on the hip which will happen in about 11 days. I use the crutches around the house and to take short walks to the deli on the corner or the park down the block and that takes a lot of energy. But I can't wait to be able to start working on the leg and get the muscles back. They are so wasted that you can really see the difference in my right leg and left leg. And then as an added joy, I've spent so much time lying on my back in the past 2 months, that I discovered a dime sized bald spot has developed on the back of my head. Like I didn't have enough to obsess over.

Most of my days are spent either lying in my bed or sitting in my office chair and it all gets kind of old. So a couple weeks ago I took advantage of my parents' offer to help me out in some way and asked them to rent me an electric scooter so I could venture further from home and run errands. Hoboken is 1.2 miles square so everything is pretty much within walking (or scooter) distance. Happily my parents obliged, so I hopped on the internet to find one. The first place I tried was a big national internet site called scootaround.com, but when they emailed me the quote I was floored. $415 + various other charges to rent one for a month! I did a bit more searching and found Wellcare Home Mobility in Hackensack, NJ, they rent the same scooters for only $125 per month! And bonus! The gentleman I spoke with was so nice and so personable. He asked the height and weight of the person needing the scooter. I said 5'7" and about 190 pounds and he said "Oh, so a smaller person." I told him I loved him...

The scooter has been great. I can get to the grocery store and the drugstore and the post office all by myself now. And today Scott and I cruised on down to the waterfront to eat our bagels for breakfast while watching the river traffic. Here's a picture Scott took of me.

It was a beautiful morning to be out and about.

I weighed myself this morning and I was down to 185.8. This is the lowest weight I've been since my sophmore year of college. I'm amazed that I keep losing especially given my reduced acivity level. The one thing I could never get a handle on in the past is getting both the eating and the exercising right at the same time. If I was exercising, I would eat more than I should. If I was eating right, I wasn't exercising like I should. So maybe this time I can get it right. We will certainly find out in a little under 2 weeks.

All right it's time for an overshare... The surgeries I had were pretty major so the scars are accordingly major. I'm stil sort of amazed by them so I've taken pictures of them.

This is my neck scar. It's still healing because I had to wear that damn neck collar 24/7. It would get no air and my neck was always hot and sweaty. Eventually, there was just a small hole there, which has now closed up. Scott commented that I would no longer be able to enter the Matrix... (sorry, geek humor)

Also notice all the tape gunk on my skin. It was weeks before I got all the gunk off my arms and my chest so I can't wait to stop having to put a dressing on my neck as well.

This is the scar that runs down my side and halfway across my lower abdomen. This is the first one I saw and the one that made me realize that my bikini wearing days are over, not that they really every got started. I haven't worn a bikini since I was about 7 years old and had nothing to fill it out with. Jeez, I never had a chance to really live I guess... Notice the the dots running down either side, those are from the staples they used to close up the incision. And there were a ton of them. I joked in the hospital that I looked like a shark bite victim.

This is the one that runs up the side of my thigh and then curves onto my lower back. There is also one more that runs straight up my butt cheek onto my lower back, but really, I've already scared you with pictures of my stomach and thigh, nobody needs to see my ass too. When I finally saw these, I realized that I had been filleted. But that's what you get when you break your acetabular and dislocate your sacro-iliac joint ( also know as, your hip socket and butt joint). I know these will fade eventually and I'm rubbing cocoa butter and vitamin E on them to help that along. But ultimately I'm not really all that bothered by them. To me, they don't represent a horrible injury. To me, they mean I'm alive. I survived a situation that could have very easily gone the other way and almost did.

Scott thinks that I should get a cool tatoo around them, like a chinese dragon twisting around the scar. Eh, maybe.

I think that's all for now. I hope nobody was eating when they saw those pictures!

Cheerios!

Twenty the hard way

It's been a while since I posted on this blog. I apologize. It seems old patterns are hard to break. I get gung ho on a project and I stick with it for a while. But then I miss a day or two or three. I swear I'm going to get back to it but as more days pass it gets harder and harder to return to it. So here I am 10 months later giving it another try.

A lot has happened in these past months. I gained back the 8 or so pounds I had lost last summer and continued my usual pattern of bouncing between 205 and 215. I watched my 16 year old niece battle anorexia and get down to around 90 pounds before having a break through and learning to get back to a healthy weight. I turned 40. And probably most significantly, at the end of April, I was in a car accident. A pretty serious car accident.

This was not my first car accident, but it's the first one in which I've been seriously injured. That day started a lot of firsts for me. The first time I've been in an ambulance. The first time I've stayed in a hospital. The first time I've broken a bone. The first time I've had major surgery. The first time I've ever had morphine. The first time I've ever had a view of my own mortality.

What happened was this...

My brother Chris picked Scott and I up early that Saturday morning in his Saturn Ion. Scott being 6'6" got the front seat, while I had to make do with the small backseat. It was a lovely morning as we headed out to Flemington, NJ. We were going to the Amish Market out there on Route 206 to get some of the world's best donuts and some pork from the pig roast they hold on the last Saturday of the month. But mostly we were going for the donuts.

We had gotten on I-78 heading west. I was sitting at an angle trying to get comfortable with the minimal amount of legroom that the Ion provides backseat passengers, especially when they are sitting behind 6'6" boyfriends. Chris and Scott were chatting away up front. I recall thinking that I should probably put on my seat belt, when it all happened very quickly. I didn't see it so I can only relay what I heard and what I was told later. We were traveling in the left lane going around 60 mph. What I was told was that the car in front of us, lost power and came to a dead stop in the lane, no lights, no warning, nothing. What I heard was my brother saying "Oh shit!" and then the unforgettable sound of one car impacting into another. Suddenly we were stopped, the airbags in the front seats were deployed and I was between the two front seats. We were all conscious and checking on each other. As I began to move myself back into the back seat, I realized something was wrong. I got the back door open and began to shift my body to get out, my left foot was hanging limply on the leg. At first I thought my ankle was broken, but as I continued to shift I realized it was the whole leg. The problem was my hip. And as the adrenalin wore off the pain started. The pain was like nothing I've ever felt before. Scott, who was relatively unhurt because he was wearing a seat belt and had an airbag, hovered helplessly and anxiously nearby. My brother was in the front seat with what we found out later was two broken legs and a broken knee. It seemed like an eternity until the EMTs arrived. And apparently it was. It took over 40 minutes for the State Police to arrive on the scene. They wouldn't call for an ambulance until they assessed the scene. So it was another 10 minutes until the EMTs arrived.

Chris said the worst moment of his life was listening to the paramedics move me out of the car, screaming in pain. From here on everything is a just blurbs of memory for me. Answering questions, begging for something for the pain, every bump in the road on the way to the hospital. One of the funny things was that whenever someone asked me what I weighed I would say "210.6". I knew precisely because I had just weighed myself that morning. At the emergency room I was still lucid enough to call another brother and sister and let them know what happened. At this point I was coming in and out of consciousness as the doctors and nurses did their work. I recall opening my eyes at one point and finding myself surrounded by all my siblings. Frankly the next 8 days of my life are pretty much lost to me. I had 2 subluxated vertebrae in my neck and a broken hip so I was heavily medicated and in traction. I had surgery on my neck the next day (Sunday) and that went well. My hip surgery however kept getting put off. Every day they would tell me that I would go in that day and every night they would say "Nevermind". Because I could not eat anything before surgery, I wasn't allowed to eat even if I wanted to (which I didn't, between the drugs and the pain, I had no appetite). I was finally taken in to the OR on Thursday. During the 14 hour surgery to repair my hip, I apparently developed bacterial pneumonia and after the surgery they were unable to extubate (remove the breathing tube) for three days. I found out later that during those three days my family was not certain that I would make it.

I spent another week in the hospital, finally able to eat something after over a week of nothing. I didn't have much of an appetite, which was okay since the hospital food was terrible, often crossing over to inedible. After that second week in the hospital I was moved to Kessler Rehabilitation Center to begin the work that would let me return home. One of the first things they did when I got there was weigh me. This was accomplished by rolling me into a sling and lifting me with this crane type thing. When the nurses aide announced "210 pounds" I couldn't believe it. Two weeks of eating nothing or next to nothing and all I lost was half a pound?!?! What's with that? It was pointed out to me that I was still very swollen and bloated from the surgeries.

That first week at Kessler, though the food was a lot better, my appetite was still very low. I would only eat about half of whatever they brought me. I was doing about 3 hours of physical therapy a day, but at least half of that would be me resting as most activities exhausted me. However, I was making progress. When they weighed me at the beginning of the next week, I was down to 202 pounds. By the second week I was getting stronger and doing more. I was eating a little more, but only at mealtimes and I never thought about searching out snacks. I progressed rapidly and before the end if the week I was swinging myself along on crutches (I've had a lot of experience with them due to my chronic knee problems). That was all the incentive the insurance company needed to kick me out of the rehab hospital and send me home. They weighed me once more before I left. I about fell over when I found out the new number: 199 pounds! I was under 200 pounds for the first time in about 15 years! I couldn't believe it. It finally happened! And all I had to do was get into a horrible car accident! Not the recommended weight loss method I have to say, but it was a nice silver lining to this difficult time.

While I was happy to be home after 4 weeks of hospitals, it wasn't as easy as I would have hoped. I felt bad that Scott had to do everything for me, including all the cooking. One of the first things he noticed was that I wasn't eating as much as I used to. I often didn't finish my meal. I've been home for about a month now and while my appetite has improved, I'm definitely not eating as much as I used to. We don't keep lots of sugary snacks in the house because both of us are watching our sugar more closely these days. I don't snack a lot because, being on crutches I can't carry it. That's not to say we haven't succumbed from time to time. Scott bribed me with a mini-cupcake if I could make it to the cupcake store on my crutches (I made it in record time!). A client send me a box of gourmet brownies. Of course, we ate them, but I limited myself to no more than one a day and I did skip a couple of days. And I made a blueberry buckle this weekend. We ate part of it and brought the rest to my brother when we went to visit.

I weighed myself this morning and I am happy to report I'm down to 187.1 pounds, that's down 23.5 pounds. According to the standard BMI charts, I am officially no longer obese, now I am merely overweight. If I lose 28 more pounds I will be a "normal" weight. Since I have finally broken that 200 barrier, I'm more confident that I can get there and possibly even to my goal weight of 145. This is the first time in a long time that it has seemed attainable.

In about 2 weeks I will be able to put weight on my left hip again and begin physical therapy to begin walking again. I'll be happy for the increased activity. Unfortunately, I will be unable to do any hiking this summer. That bums me out a bit.

The accident was definitely a life changing moment, but the silver linings I have discovered are many, the weight loss jump start is just one small one. After a lifetime of feeling unlovable, I learned that I am well and truly loved. I learned that I have the most amazing brothers and sisters who circle the wagons when crisis strikes. And I learned that I have an incredible support system of friends and family that I never really understood was always there. I've always been a very independent person and I have a hard time asking for anything. I can't thank all the people who have been there for me during this time enough. I think I'm going to come out of this a much lighter person, both physically and mentally.

Cheerios!